The medical diseases of children . lderchildren. Hepatic Cirrhosis.—The liver is very frequently affected ininherited syphilis, but only seldom gives rise to any clinical 1S6 INFECTIVE DISEASES symptoms. The commonest change is that of a diffuse, fine, inter-cellular fibrosis. The capsule of the liver may be unaffected, or maybecome slightly adherent. Occasionally it is thickened, and firmlyadherent to the liver. In some cases the liver is irregular in shape,apart from the presence of gummata. Such a liver is shown in Fig. of the organ are contracted, as the result of the cirrhosis
The medical diseases of children . lderchildren. Hepatic Cirrhosis.—The liver is very frequently affected ininherited syphilis, but only seldom gives rise to any clinical 1S6 INFECTIVE DISEASES symptoms. The commonest change is that of a diffuse, fine, inter-cellular fibrosis. The capsule of the liver may be unaffected, or maybecome slightly adherent. Occasionally it is thickened, and firmlyadherent to the liver. In some cases the liver is irregular in shape,apart from the presence of gummata. Such a liver is shown in Fig. of the organ are contracted, as the result of the cirrhosis,while in other parts there appears to have been an attempt at com-pensatory hypertrophy of the liver tissue. Associated with the cirrhotic changes may be gummata, oftenmiliary in infants, and larger in the case of older children. The liveris occasionally of a bright green colour in infantile cases. Where clinical symptoms of cirrhosis of the liver are present, thechild is brought to the doctor for enlargement of the abdomen. On. Fig. 41.—Inherited Syphilis : Liver showing Perihepatitis, Fibrosis, AND AREAS OF HYPERTROPHY. examination, there are found to be ascites, enlargement of the liverand of the spleen. The diagnosis of syphilitic cirrhosis of the livercan hardly be made with certainty unless other signs of the infectionare present, or there is a very suggestive family history. Tuberculousperitonitis is the commonest cause of ascites in children, and this,together with malignant disease of the liver or of the glands in theportal fissure, are the conditions which very closely simulate syphiliticcirrhosis. With treatment by mercury and iodide, recovery may occur inolder children; but in infants the condition is usually fatal. Jaundice.—Jaundice may be present at birth in syphilitic often it appears a little later. In both cases it is usuallv fatalif due to this disease. In some instances it is due to syphiliticobstruction of the common bile-duct. SYPHILIS
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectpediatrics, bookyear1
